scholarly journals Designing Decentralized Ledger Technology for Electronic Health Records

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Vikram Dhillon
Keyword(s):  
Electronic Health Records ◽  
Open Source ◽  
Digital Health ◽  
Health Records ◽  
Distributed Ledger ◽  
Distributed Ledger Technology ◽  
Electronic Health

No abstract available. Editor’s note: A proposal to implement distributed ledger technology for electronic health records is outlined here. The rationale for integration of distributed ledgers in the healthcare domain is introduced, followed by a discussion of the features enabled by the use of a blockchain. An open source implementation of a distributed ledger is then presented. The article concludes with an examination of opportunities and challenges ahead in deploying blockchains for digital health.

scholarly journals A Mechanism for Verifying the Integrity and Immutability of Tuberculosis Data Using IOTA Distributed Ledger Technology

2021 ◽  
Author(s):  
Vinícius Lima ◽  
Filipe Bernardi ◽  
Rui Rijo ◽  
Jó Ueyama ◽  
Domingos Alves
Keyword(s):  
Electronic Health Records ◽  
Digital Health ◽  
Health Records ◽  
Related Information ◽  
Research And Innovation ◽  
Distributed Ledger ◽  
Collective Process ◽  
Supporting Tool ◽  
Electronic Health ◽  
Digital Transactions

Background: Intensified research and innovation and rapid uptake of new tools, interventions, and strategies are crucial to fight Tuberculosis, the world’s deadliest infectious disease. The sharing of health data remains a significant challenge. Data consumers must be able to verify the consistency and integrity of data. Solutions based on distributed ledger technologies may be adequate, where each member in a network holds a unique credential and stores an identical copy of the ledger and contributes to the collective process of validating and certifying digital transactions. Objectives: This work proposes a mechanism and presents a use case in Digital Health to allow the verification of integrity and immutability of TB electronic health records. Methods: IOTA was selected as a supporting tool due to its data immutability, traceability and tamper-proof characteristics. Results: A mechanism to verify the integrity of data through hash functions and the IOTA network is proposed. Then, a set of TB related information systems was integrated with the network. Conclusion: IOTA technology offers performance and flexibility to enable a reliable environment for electronic health records.

HealthChain: A Blockchain for Electronic Health Records (Preprint)

2019 ◽  
Author(s):  
Yonggang Xiao ◽  
Yanbing Liu ◽  
Yunjun Wu ◽  
Tun Li ◽  
Xingping Xian ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Functional Requirements ◽  
Care Providers ◽  
Health Records ◽  
Blockchain Technology ◽  
Distributed Ledger ◽  
Electronic Health

BACKGROUND The maintenance of accurate health records of patients is a requirement of health care professionals. Furthermore, these records should be shared across different health care organizations in order for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to accomplishment of these jobs and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as the concern about performance and privacy issues. OBJECTIVE The aim of this paper is to build and evaluate an experimental blockchain for EHRs, named HealthChain, which addresses the disadvantages of traditional EHR systems. METHODS HealthChain is built based on consortium blockchain technology. Specifically, three stakeholders, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Peer nodes host instance of the distributed ledger consisting of EHRs, and instance of chaincode regulating the permissions of participants; designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers. RESULTS HealthChain achieves the functional and non-functional requirements. While it can store EHRs in distributed ledger and share them among different participants, it demonstrates superior features, such as privacy preserving, security, and high throughout. These are the main reasons why HealthChain is proposed. CONCLUSIONS Consortium blockchain technology can help build EHR system and solve the problems that prevent the adoption of traditional ones.

scholarly journals Open source electronic health records and chronic disease management

2014 ◽  
Vol 21 (e1) ◽  
pp. e50-e54 ◽  
Author(s):  
Jason C Goldwater ◽  
Nancy J Kwon ◽  
Ashley Nathanson ◽  
Alison E Muckle ◽  
Alexa Brown ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
Electronic Health Records ◽  
Open Source ◽  
Chronic Disease Management ◽  
Health Records ◽  
Electronic Health

scholarly journals Digital Health and the State of Interoperable Electronic Health Records (Preprint)

2018 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

UNSTRUCTURED Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

scholarly journals The use of open source electronic health records within the federal safety net

2014 ◽  
Vol 21 (2) ◽  
pp. 280-284 ◽  
Author(s):  
Jason C Goldwater ◽  
Nancy J Kwon ◽  
Ashley Nathanson ◽  
Alison E Muckle ◽  
Alexa Brown ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Open Source ◽  
Safety Net ◽  
Health Records ◽  
Electronic Health

scholarly journals Electronic Health Records

2021 ◽  
pp. 74-84
Author(s):  
Eric D. Perakslis ◽  
Martin Stanley
Keyword(s):  
Electronic Health Records ◽  
Digital Health ◽  
Healthcare Spending ◽  
Lessons Learned ◽  
Health Records ◽  
Risks And Benefits ◽  
Clinical Encounters ◽  
Potential Risks ◽  
Electronic Health

A key opportunity for anticipating and understanding the potential risks and benefits of digital health is readily available in the form of electronic health records (EHRs). Touted as a transformation in health care and funded by tens of billions of dollars in federal investment, the outcomes remain mixed. Although the anticipated benefits of increased visibility to healthcare spending and utilization are real, the massive ongoing expense, the time taken away from clinical encounters, and the massive burden on clinicians are all frequently reported unsolved problems. The need to address all stakeholders, to obtain objective measurement, to spend equal time spent examining risks and benefits, and to achieve long-term sustainability are just a few examples of lessons learned from the implementation of EHRs that should be applied to digital health.

scholarly journals Patient Rationales Against the Use of Patient-Accessible Electronic Health Records: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Hanne Støre Valeur ◽  
Anne Kveim Lie ◽  
Kåre Moen
Keyword(s):  
Health Services ◽  
Electronic Health Records ◽  
Social Life ◽  
Digital Health ◽  
Emotional Reactions ◽  
The Internet ◽  
Medical Terminology ◽  
Digital Competence ◽  
Health Records ◽  
Electronic Health

BACKGROUND Patient-accessible electronic health records (PAEHRs) enable patients to access their health records through a secure connection over the internet. Although previous studies of patient experiences with this kind of service have shown that a majority of users are positive toward PAEHRs, little is known about why some patients occasionally or regularly choose not to use them. A better understanding of why patients may choose not to make use of digital health services such as PAEHRs is important for further development and implementation of services aimed at having patients participate in digital health services. OBJECTIVE The objective of the study was to explore patients’ rationales for not embracing online access to health records. METHODS Qualitative interviews were conducted with 40 patients in a department of internal medicine in a Norwegian hospital in 2018-2019. Interview transcripts were subjected to thematic content analysis. In this paper, we focus on the subject of nonuse of PAEHRs. RESULTS We identified 8 different rationales that study participants had for not embracing PAEHRs. When patients reflected on why they might not use PAEHRs, they variously explained that they found PAEHRs unnecessary (they did not feel they were useful), impersonal (they preferred oral dialogue with their doctor or nurse over written information), incomprehensible (the records contained medical terminology and explanations that were hard to understand), misery oriented (the records solely focused on disease), fear provoking (reading the records could cause unwanted emotional reactions), energy demanding (making sense of the records added to the work of being a patient), cumbersome (especially among patients who felt they did not have the necessary digital competence), and impoverishing (they were skeptical about the digital transformation of individual and social life). CONCLUSIONS It is often assumed that the barriers to PAEHR use are mostly practical (such as lack of hardware and access to the internet). In this study, we showed that patients may have many other valid reasons for not wanting to adopt this kind of service. The results can help guide how PAEHRs and other digital health services are promoted and presented to patients, and they may suggest that the goal of a given new digital health service should not necessarily be full uptake by all patients. Rather, one should recognize that different patients might prefer and benefit from different kinds of “analog” and digital health services.

scholarly journals Patient Rationales Against the Use of Patient-Accessible Electronic Health Records: Qualitative Study

10.2196/24090 ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. e24090
Author(s):  
Hanne Støre Valeur ◽  
Anne Kveim Lie ◽  
Kåre Moen
Keyword(s):  
Health Services ◽  
Electronic Health Records ◽  
Social Life ◽  
Digital Health ◽  
Emotional Reactions ◽  
The Internet ◽  
Medical Terminology ◽  
Digital Competence ◽  
Health Records ◽  
Electronic Health

Background Patient-accessible electronic health records (PAEHRs) enable patients to access their health records through a secure connection over the internet. Although previous studies of patient experiences with this kind of service have shown that a majority of users are positive toward PAEHRs, little is known about why some patients occasionally or regularly choose not to use them. A better understanding of why patients may choose not to make use of digital health services such as PAEHRs is important for further development and implementation of services aimed at having patients participate in digital health services. Objective The objective of the study was to explore patients’ rationales for not embracing online access to health records. Methods Qualitative interviews were conducted with 40 patients in a department of internal medicine in a Norwegian hospital in 2018-2019. Interview transcripts were subjected to thematic content analysis. In this paper, we focus on the subject of nonuse of PAEHRs. Results We identified 8 different rationales that study participants had for not embracing PAEHRs. When patients reflected on why they might not use PAEHRs, they variously explained that they found PAEHRs unnecessary (they did not feel they were useful), impersonal (they preferred oral dialogue with their doctor or nurse over written information), incomprehensible (the records contained medical terminology and explanations that were hard to understand), misery oriented (the records solely focused on disease), fear provoking (reading the records could cause unwanted emotional reactions), energy demanding (making sense of the records added to the work of being a patient), cumbersome (especially among patients who felt they did not have the necessary digital competence), and impoverishing (they were skeptical about the digital transformation of individual and social life). Conclusions It is often assumed that the barriers to PAEHR use are mostly practical (such as lack of hardware and access to the internet). In this study, we showed that patients may have many other valid reasons for not wanting to adopt this kind of service. The results can help guide how PAEHRs and other digital health services are promoted and presented to patients, and they may suggest that the goal of a given new digital health service should not necessarily be full uptake by all patients. Rather, one should recognize that different patients might prefer and benefit from different kinds of “analog” and digital health services.

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